NOTE: THIS PAPER IS STILL IN REVIEWS
Goal of the study?
To evaluate the frequency of lesions (injuries) in the lumbar region (lower back) of asymptomatic adolescent soccer players using MRI.
Why are they doing this study?
To date, there are very few studies that look at the frequency of spinal lesions in young athletes. Most of the research has focused on adult athletes and has shown that the lower back region is the most common site for problems. However, we know that the pediatric musculoskeletal system is particularly at risk to injury because adolescent bodies have not finished growing. Injuries at such a young age can result in an imbalance in bone tissue and muscles, which may cause an increased risk of injury, pain and limit young adolescents’ daily activities. These injuries can also get worse as we age. Therefore, it’s important to know if adolescent soccer players are getting lower back lesions that are not being identified and treated.
Who was involved?
The study 1 looked at two groups of asymptomatic male adolescents aged 13-18.
- Soccer players who practiced the sport for at least two consecutive years, at least three times per week for 1-3 hours.
- Control group was made up of asymptomatic adolescents and was matched for age, gender, height and weight. They could not play soccer or any other sport more than once a week for more than 1 hour.
- No one in the study could have any history of lesions, surgery, chronic disease or a high BMI score.
- While they originally recruited 60 adolescents (30 in each group), because of exclusions the final sample size was 45.
What was done?
The researchers used MRI to evaluate the spine and look for the frequency of lesions in the lower back of adolescent soccer players.
Two different radiologists examined the MRI images looking for the presence or absence of swelling, protrusions and disc extrusions (bulges). They also looked at stress reactions, cracks or stress fractures in the vertebras, vertebras slipped out of place, enlargements or growths, as well as swelling of the interspinal ligaments and muscles.
What did they find?
Comparing the two groups, the researchers found that the proportion of spinal lesions was 76% in the soccer players compared to only 35% of the control group. In particular, they found that the percentage of lesions in the anterior and posterior of the spine was significantly higher in the soccer players than the control group. They did not find any significant differences between the age and BMI Z-scores between the two groups.
This study was able to show a high number of lesions in soccer players compared to other youth soccer studies that did not use MRI. However, research on young athletes playing other sports shows a similar frequency of spinal lesions.
What are the limitations?
This study had a very small number of participants. Also, all of the soccer players were studied during their championship season. This means it is likely that they are doing more intense training and playing than during regular season. As of Dec 28, 2020, the paper is still under review and going through the editorial process.
Why do these findings matter?
Lower back injuries in childhood and adolescence can lead to early degenerative changes. Therefore, the high number of lower back lesions in adolescent soccer players should be considered in the changing landscape of a person’s spinal health. Sport specific prevention efforts are important to reduce the occurrence and impact of lower back injuries on young adolescents. Better identification and management of spinal lesions may help to ensure that young people are able to continue playing sport and reduce the impact of these injuries in adulthood and into their senior years to avoid conditions like lumbar spinal stenosis. Learning recovery strategies show promise.